Showing posts with label pain. Show all posts
Showing posts with label pain. Show all posts

Muscular Imbalances


“Our own physical body possesses a wisdom which we who inhabit the body lack.  We give it orders which make no sense.”           ~Henry Miller

            Balance can be defined as a harmonious state of equilibrium, and it is what we strive for:  a balanced lifestyle, a balanced diet and a balanced emotional state.  Dancers need to add muscular balance to that list.

            Our bodies function best when they are in this harmonious state of equilibrium.  Most physical activities, like dance, focus on certain muscle groups.  Unless the dancer is aware of how the muscular system works, there is potential for muscular imbalances to occur.

            The human body is built in a balanced manner.  Muscles exist and function in pairs.  The working, or contracting, muscle is the agonist, and the opposing muscle is the antagonist.  As the agonist shortens to pull on the skeleton, the antagonist must lengthen to allow the movement to occur.  When a dancer points his or her foot, the muscles of the calf contract to pull the heel up toward the knee.  The muscles of the shin must relax and lengthen so the arch of the foot and the toes can move away from the knee.  When a dancer flexes his or her foot, the exact opposite action occurs.  The muscles of the shin contract while the calf muscles lengthen.

            When a muscle group is worked repeatedly, that group grows tighter.  If the agonists are not stretched to preserve flexibility, and the antagonists are not worked equally, a muscular imbalance occurs.  The tighter and stronger muscles lack necessary flexibility and are at a greater risk of being injured during activity. 

            Muscles are similar to elastics.  A thicker shorter elastic will break sooner than a long thin elastic when it is forcefully lengthened.  A muscle will react similarly.  When a short, tight muscle must be extended quickly, a muscle strain or tear is more likely to occur.

            Additionally, since our muscles are attached to our skeletons, tighter muscles will pull on the skeleton at rest, and the weaker, longer muscles will allow it, causing bones to be put into unnatural positions that cause pain.

            While all dancers need to be concerned about muscular imbalances, ballet dancers are especially at risk because of the turnout that ballet requires.  The muscles that outwardly rotate the leg are worked constantly in ballet.  Quite often, ballet dancers stand out in a crowd because the external rotators are so tight that their pedestrian walk resembles a duck walk.  The sciatic nerve passes through the group of external rotator muscles and will get pinched if the muscles are tight, causing pain.  The external rotators connect to the pelvis and lower vertebrae.  When they are tight, they pull on the pelvis and vertebrae in a way that decreases the natural curve of the lumbar spine.  This action puts stress on the lumbar-sacral joint and reduces the shock absorption quality of the spine, causing lower back strain.

            Dancers who work with pointed feet for a majority of the time run the risk of creating an imbalance in the lower leg.  In addition to working with pointed feet, some dancers allow their heels to “pop up” during second position grand pliés and do not place their heels down in between jumps and relevés.  Since the heels are constantly raised, the calf muscles are never lengthened and grow tighter, while the shin muscles grow weaker.  As this continues, the entire weight of the body is shifted forward, and the body is forced to compensate for the change in the center of gravity.  Additionally, the shortening of the calf muscles strains the Achilles tendon, which is the tendon that connects these muscles to the heel.  This strain causes tendon irritation that will result in tendonitis.

            These are just a few of the muscular imbalances that can occur.  These imbalances cause the body to compensate in various ways that alter the skeletal foundation because of the muscular force exerted upon the bones.  The solution is a simple one that involves stretching the muscles after they are worked.  The strength of the muscles will not be altered, and the length of the muscles will be preserved.  Additionally, dancers can use various forms of cross training to strengthen all the muscle groups equally.  By avoiding muscular imbalances, dancers can dance efficiently, prevent injuries, avoid pain and lengthen their careers by preserving their carefully crafted instruments.

Caring For Injuries

There are three steps you have to complete to become a professional dancer: learn to dance, learn to perform, and learn how to cope with injuries. – D. Gere

             Pain is normally the first sign of an injury and is our body’s built-in alarm system that tells us something is wrong.  Shortly after the pain comes the swelling.

            Swelling is a natural reaction to an injury and occurs in order to promote healing.  When an injury occurs, cell tissue gets damaged, and the body receives a message to begin repairing this tissue.  Blood flow to the area increases as the body sends leukocytes (white blood cells) to the area.  Leukocytes are macrophages, which are the body’s “clean up crew”.  They migrate to the injured area and carry away the damaged tissue fragments.  Proteins are also released into the area to start repairing the tissue.  A hormone called Insulin-like Growth Factor 1 is also released into the area, which has been shown to increase the rate of cell regeneration.  The initial release of these fluids is necessary for the healing process, but the body overproduces these substances, and a large amount of swelling occurs.

            Applying ice to the injured area causes the blood vessels to contract and decreases the accumulation and circulation of the fluids.  Ice should be applied to the injury 3 times a day for 20-minute periods for the first 48-72 hours.  Ice that is left on an area for longer than 20 minutes at a time can damage the skin.  Ice also serves to numb the nerve endings and temporarily relieve any pain.  It is because of this numbing, that dancers should never use ice before dancing.  Since the area is numb, the dancer has no way of knowing if he/she is doing more damage.

            Other ways to limit swelling at the injured site are to take ibuprofen, compress the injury and elevate the injured limb.  Ibuprofen will decrease the inflammation and help to ease the pain.  Acetaminophen can help with pain management but does not decrease swelling.  Compression will minimize swelling by not allowing room for fluids and can be accomplished through the use of a brace or ace bandage.  Elevating a limb above the heart will limit the flow of blood and fluids to the injured area.

            Obviously, an injured area also needs to be rested in order to heal.  All of these treatments can be remembered by using the acronym RICE (rest, ice, compression, elevation). 
           
            After the first three days, heat can be applied to the injury.  After the swelling subsides, encouraging blood flow to the site will provide the nourishment necessary for healing.  It is best to apply moist heat and avoid analgesics like Tiger balm and Ben-gay.  Analgesics contain methyl salicylate and menthol.  These ingredients increase blood flow to the skin, which makes it feel as if the area is being heated when in reality the warmth goes no deeper than the skin.

            As healing continues, gentle stretching will help encourage flexibility in the newly formed scar tissue which will not be as pliable as the original tissue.  It is more effective to stretch often for short intervals than to stretch for a long period of time.

            All injuries should be evaluated and treated by a doctor, but dancers who have information about how to treat the injury immediately improve their chances for a shorter recovery time than those who do nothing.